Menstrual pain in Danish women correlated with low n-3 polyunsaturated fatty acid intake.Deutch B: Aarhus University, DenmarkEur J Clin Nutr 1995 Jul 49:508-16Abstract OBJECTIVES: The hypothesis tested was that menstrual discomfort, e.g. dysmenorrhoea, known to be prostaglandin-mediated, can be influenced by the dietary ratio of n-3 and n-6 polyunsaturated fatty acids. The prostaglandins derived from marine n-3 fatty acids are normally less aggressive and therefore expected to be associated with milder symptoms. DESIGN: The question was surveyed in an epidemiological study based upon self-administered questionnaires concerning menstrual history, present symptoms, general health, socioeconomic factors, and general dietary habits. Two (prospective) 4-day dietary records were used to estimate average daily nutrient intake. SUBJECTS: The subjects were recruited by advertising (about 220 volunteered); 181 healthy Danish women were selected, aged 20-45 years; they were not pregnant and did not use oral contraceptives. RESULTS: No correlations were found between socioeconomic or anthropometric data and menstrual problems. On the contrary certain dietary habits, e.g. low intake of animal and fish products, and intakes of specific nutrients, were correlated with menstrual pain. The average dietary n-3/n-6 ratio of women with menstrual pain was 0.24. It was significantly higher among those with low intake of B12 coincident with low intake of n-3 (0.42, P < 0.001) (chi-square), with low n-3 intake coincident with low n-3/n-6 ratio (0.42, P < 0.005), and finally with low intake of B12 coincident with low n-3/n-6 ratio (0.47, P < 0.001). CONCLUSION: The results were highly significant and mutually consistent and supported the hypothesis that a higher intake of marine n-3 fatty acids correlates with milder menstrual symptoms.

Painful menstruation and low intake of n-3 fatty acids.Deutch B: Specialkursus i Husholdning, Aarhus Universitet, Denmark Ugeskr Laeger 1996 Jul 158:4195-8AbstractMenstrual pain, dysmenorrhea, which is known to be prostaglandin mediated, can possibly be influenced by the dietary ratio of omega-3 and omega-6 polyunsaturated fatty acids. The prostaglandins derived from marine omega-3 fatty acids are normally less aggressive and therefore expected to be associated with milder menstrual symptoms. This hypothesis was surveyed in an epidemiological study in Danish women based upon self administered questionnaires concerning menstrual history, present symptoms, general health, socio-economic factors, and general dietary habits. Two prospective four-day dietary records were used to estimate average daily nutrient intake. The subjects were recruited by advertising, they were 20-45 years of age, not pregnant, and did not use oral contraceptives. No correlations were found between socioeconomic or anthropometric data and menstrual problems. However, certain dietary habits e.g. low intakes of animal and fish products, and low intakes of specific nutrients (omega-3 PUFA, B12 and omega-3/omega-6 ratio) were correlated with menstrual pain. The other nutrients in the diet were not significantly related to menstrual pain. The results were highly significant and mutually consistent and supported the hypothesis that a higher intake of marine, omega-3 fatty acids correlate with milder menstrual symptoms.

Leukotriene release by endometrium and myometrium throughout the menstrual cycle in dysmenorrhoea and menorrhagia.Rees MC, DiMarzo V, Tippins JR, Morris HR, Turnbull ACJ Endocrinol 1987 May 113:291-5AbstractEndometrium and myometrium were collected at hysterectomy from 21 women with measured menstrual blood loss. Eight women complained of dysmenorrhea and the remaining 13 had pain-free periods. Specimens were obtained throughout the menstrual cycle (menstrual, n = 5; follicular, n = 4; early luteal, n = 3; mid-luteal, n = 5; late luteal, n = 4). Leukotriene C4, leukotriene D4 and leukotriene E4 release were examined using a short-term incubation technique. Endometrial leukotriene release, which was always significantly greater than myometrial release, changed throughout the menstrual cycle and the highest concentrations were found during menstruation. Endometrial, but not myometrial, leukotriene concentrations were significantly higher in tissues obtained from women with a complaint of dysmenorrhoea compared with those in tissue from pain-free women. No correlation was found between leukotriene release in either endometrium or myometrium and menstrual blood loss (range 15-457 ml).

Supplementation with omega-3 polyunsaturated fatty acids in the management of dysmenorrhea in adolescents.Harel Z: Division of Adolescent Medicine, Children's Hospital Medical Center, Cincinnati OH, USA; Biro FM, Kottenhahn RK, Rosenthal SLAm J Obstet Gynecol 1996 Apr 174:1335-8AbstractOBJECTIVES: The purpose of the study was to examine whether dietary supplementation with omega-3 fatty acids can relieve symptoms of dysmenorrhea in adolescents. STUDY DESIGN: Forty-two adolescents with dysmenorrhea were randomly allocated to two groups. In the first group 21 girls received fish oil (1080 mg eicosapentaenoic acid, 720 mg docosahexaenoic acid, and 1.5 mg vitamin E) daily for 2 months followed by a placebo for an additional 2 months. In the second group 21 girls received placebo for the first 2 months, followed by fish oil for 2 more months. The Cox Menstrual Symptom Scale was used to assess response to treatment. RESULTS: There were no significant differences in the Cox Menstrual Symptom Scale between the two groups at baseline after 2 months of placebo administration. After 2 months of treatment with fish oil there was a marked reduction in the Cox Menstrual Symptom Scale from a baseline mean value of 69.9 to 44.0 (p < 0.0004). CONCLUSIONS: This study suggests that dietary supplementation with omega-3 fatty acids has a beneficial effect on symptoms of dysmenorrhea in adolescents.

Epidemiology of adolescent dysmenorrhea.Klein JR, Litt IFPediatrics 1981 Nov 68:661-4AbstractDysmenorrhea is the leading cause of recurrent short-term school absenteeism among adolescent girls. Controversy surrounds the relative role of psychologic and biologic variables in the pathogenesis of dysmenorrhea. Therefore, data from 2,699 menarcheal adolescents, drawn from a national probability sample of 12 to 17-year-old girls (the National Health Examination Survey), were analyzed by bivariate and multivariate analytic techniques for biologic, psychologic, and demographic correlates of dysmenorrhea. Of 1,611 adolescents (59,7%) who report dysmenorrhea, 14% frequently miss school because of cramps. The greatest proportion of variation of independent variables in a stepwise multiple regression analysis in this study was predicted by gynecologic or postmenarcheal age. Preparation for menarche, a psychologic variable, did not predict either dysmenorrhea or subsequent school absence. Socioeconomic status was positively correlated with dysmenorrhea although race was not. However, black students (23.6%) miss more school because of dysmenorrhea than white students (12.3%) even when socioeconomic status is held constant. Data in this study suggest that biologic variables play a substantial role in the pathogenesis of dysmenorrhea.